Bedinvetmab

What is bedinvetmab?

Bedinvetmab (Librela®) is an immunotherapeutic/biologic medication used to alleviate osteoarthritic pain in dogs.

It is a monoclonal antibody therapy that reduces pain signaling between the arthritic joint and the central nervous system by binding and neutralizing nerve growth factor (NGF). Bedinvetmab is only used in dogs.

How is bedinvetmab administered?

Bedinvetmab is given by an injection under the skin at the veterinary clinic. 

Improvements in your dog’s mobility may be noticed within a few days to weeks of the injection; however, it may take more than one month of use before optimal results are reached.

What if I miss giving a dose to my dog?

Give the missed dose as soon as you remember and then wait for the recommended amount of time between doses. Never give your pet two doses at once and never give extra doses.

Are there any potential side effects?

Side effects seen during clinical trials of Librela include:

• mild reactions at the injection site (heat, swelling, pain)

Since the FDA approved this drug, there have been reports of adverse effects associated with the use of bedinvetmab. These effects include:

• anaphylactic reaction
• ataxia (loss of muscle control or coordination)
• death
• diarrhea
• increased drinking and urination
• lethargy
• loss of appetite
• muscle weakness or tremors
• paresis or paralysis
• seizure
• urinary incontinence
• vomiting

There have been very rare reports of signs of immune-mediated diseases like hemolytic anemia (red blood cell destruction) or thrombocytopenia (low blood platelets). These rare and very rare side effects were reported in pets receiving bedinvetmab, but that does not necessarily mean they were caused by the medication.

Serious adverse reactions associated with this drug may occur without warning and could, in rare cases, lead to death. Contact your veterinarian immediately if you notice anything out of the ordinary and ensure all follow-up lab work and exams are completed as directed by your veterinarian.

Long-term side effects occurring more than nine months after using bedinvetmab have not been evaluated.

If inadvertent human dosing occurs, contact your physician immediately.

Are there any risk factors for this medication?

Bedinvetmab should NOT BE USED in dogs that are:

• allergic or sensitive to it
• breeding, pregnant, or nursing
• Under 12 months of age

Bedinvetmab should be USED WITH CAUTION in:

• large breed dogs whose bone growth is not complete 
• dogs who receive other monoclonal antibody treatment
• dogs who are on non-steroidal anti-inflammatory medications (NSAIDs)
• dogs who have pre-existing diseases 

If your dog is given bedinvetmab at a scheduled vaccination visit, it should be injected at a different site on the body than where the vaccines are injected.

Are there any drug interactions I should be aware of?

At the time of this handout’s publishing, drug interactions have not been reported. The chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) with bedinvetmab has not been evaluated in dogs. In human trials of human anti-NGF monoclonal antibody therapy, some patients also receiving NSAIDs developed rapidly progressing osteoarthritis (RPOA). This condition has never been reported in dogs.

It is important to regularly review all your dog’s vitamins, supplements, medications, and herbal therapies with your veterinarian.

Is any monitoring needed with this medication?

• Before your dog starts bedinvetmab, your veterinarian may recommend baseline bloodwork and urinalysis. 
• During long-term use, your veterinarian may recommend periodic monitoring with blood, urine and recheck examinations to ensure your dog’s pain is adequately managed and to screen for underlying conditions that may affect treatment.
• At home, monitor for any side effects such as those noted above. If any side effects occur, contact your veterinarian. Side effects should also be reported to the manufacturer.

It is important to note that dogs with reduced mobility, secondary to arthritic pain, may over-exercise when they start bedinvetmab. To prevent injury, a gradual return to exercise over a few weeks has been recommended. 

Because of the nature of all monoclonal antibody therapies, a decrease in efficacy with repeated administration is possible, as dogs may develop antibodies to the therapy product (anti-drug antibodies).

How do I store bedinvetmab?

• Store this medication in the refrigerator, in its original package. 
• Store between 35°F and 46°F (2°C and 8°C). 
• Protect it from light and from freezing. 
• Discard vials after use in accordance with local waste requirements.

What should I do in case of an emergency?

Call your veterinary office immediately if you suspect an overdose or an adverse reaction to the medication. If they are unavailable, follow their directions to contact an emergency facility.